A Randomized Crossover Design to Assess Learning Impact and Student Preference for Active and Passive Online Learning Modules

Active Learning Among Health Professions' Educators: Perceptions, Barriers, and Use

Introduction

Active learning engages students in the learning process through meaningful learning activities. Despite evidence that active learning can improve student's comprehension and problem solving, many educators remain reluctant to adopt it. The goal of this study was to explore health professions' educators' perceptions of active learning and identify implementation barriers.

Materials and Methods

We developed a 25-question survey based on the Miller and Metz "perceptions of active learning" survey. We added 12 single-response demographics questions to the original 13 survey questions.

Results

One hundred three respondents completed the survey. We found positive perceptions of active learning significantly correlated with gender, rank, teaching FTE, and full-time employment. The use of specific active learning modalities significantly correlated with gender, terminal degree, institutional appointment, academic rank, and role. Lack of time to develop materials and lack of class time were the most common personal barriers identified, while being lecture-accustomed and lack of training were the most common perceived barriers to the implementation of active learning by their peers.

Conclusion

Despite overwhelmingly positive perceptions of active learning among US health professions' educators and desire to incorporate it, a gap still exists between institutional and educators' support of active learning due to implementation barriers for resource-intensive active learning.

An educational intervention to promote a culture of gender equity among persons with traumatic brain injury and caregivers: A pilot study

Background

Traumatic brain injury (TBI) outcomes are dependent on patients' biological sex (e.g., hormone levels) and sociocultural gender (e.g., norms, responsibilities). Informal caregivers additionally experience disruptions to identity and roles post-TBI. However, information on this topic remains largely unavailable to patients and caregivers.

Purpose

This study aimed to determine the effectiveness of a one-time educational intervention on sex and gender influences in TBI for patients and informal caregivers.

Materials and methods

We conducted a pilot pre-test/post-test randomized control-group design study. Groups (i.e., passive, active and control) consisted a total of 16 persons with TBI and caregivers (75% persons with TBI, 63% women). Individual and group learning gains, and group-average normalized gain, were computed for three learning domains: knowledge, attitude, and skill. An intervention with an average normalized gain of ≥30% was considered effective. Educational intervention evaluation and qualitative comments post-participation were summarized.

Results

The passive group demonstrated the highest average normalized gain across the three learning domains, including 100% for knowledge, 40% and 61% for attitude, and 37% for skill. The remaining groups did not reach an average normalized gain of ≥30%, except for the attitude domain of the control group (33% and 32%). Two key categories were identified qualitatively: (1) gendered self-expectations post-injury and (2) implications of gender stereotypes in rehabilitation, including the need for rehabilitation treatment to look beyond sex and gender. The post-participation educational session evaluation conveyed high appraisal of content, organization, and usability of the intervention.

Conclusion

A one-time passive educational intervention on sex and gender in TBI may improve knowledge, attitude, and skill on the topic of sex and gender among adults with TBI and caregivers. Obtaining knowledge and skill on sex and gender effects in TBI can potentially help persons with TBI and caregivers adapt to changes in roles and behaviours post-injury.

Coping with the impact of Covid-19 pandemic on primary education: teachers' struggle (case study in the Province of Yogyakarta, Indonesia)

Purpose

The research aimed to explore the issues in the implementation of online education practice in elementary school, to study teachers' coping strategy to the online education issues and to evaluate teachers' problem-solving skill in online learning practice during the Covid-19 pandemic.

Design/methodology/approach

An exploratory research focused on identifying the obstacles in teaching practice faced by elementary school teachers as well as their coping strategy with eight convenience sampled schools.

Findings

Online education practice faced unpreparedness and competency issues. Unpreparedness was found in terms of social, technical and cultural factors, while competency issue was related to online education competency and digital competency. Teachers’ struggle to cope with the issue in online education practice was focused on the performing conventional education in the online manner, suggesting teachers' lack of competency in encouraging learning success. Teachers neglected the development of students' readiness and competencies to engage in online learning. Moreover, teachers’ struggle had the least impact on the development of their online teaching competency and digital competency that are required for carrying out online teaching. In general, teachers' problem-solving skill was below the expected level. These findings suggested that improvement of teachers' competencies is important in order to cope with the issues such as in online education practice during Covid-19 pandemic and to face future challenges in education.

Originality/value

This study evaluated the gap between actual action and expected action of elementary school teachers in coping with the issues regarding online education practice.

Comparison between two asynchronous teaching methods in an undergraduate dental course: a pilot study

BACKGROUND

Properly designed and implemented eLearning can lead to improvement of dental teaching quality. Various strategies have been proposed to increase the effectiveness of eLearning in dental education, however, there is a lack of research to assess the effectiveness of these strategies.

OBJECTIVE

To investigate dental students' learning performance and perception of a virtual flipped learning format compared to a virtual traditional learning method.

METHODS

A crossover pilot study was conducted at the College of Dentistry, Princes Sattam Bin Abdulaziz University, Saudi Arabia. Computer-generated randomization, blinded from researchers who analyzed the results, was performed to allocate 32 participants (aged 23.27 ± 0.86 years) to one of two groups. Participants in the control group were taught through the virtual traditional learning method (VTL) using live video lectures. In contrast, participants in the intervention group were taught through the virtual flipped learning method (VFL) using recorded online lectures and post-lecture virtual discussions. Learning gain and preference were measured by pre- and post-test average score differences and a modified validated survey, respectively.

RESULTS

There was no significant difference in learning performance between VFL and VTL groups (P > 0.05). However, students preferred VFL over VTL and the differences were significant among all survey items, except for the opportunity to ask questions.

CONCLUSION

Health professions educators are encouraged to carefully design online curricula with efficient learning strategies that help students improve learning performance and foster self-directed learning skills while valuing active learning in an online environment.

TRIAL REGISTRATION

NCT04692142 , 31/12/2020.

Comparison of an e-learning package with lecture-based teaching in the management of supraventricular tachycardia (SVT): a randomised controlled study

INTRODUCTION

To compare the impact of an e-learning package with theoretical teaching on the ability of both graduate and undergraduate medical students to learn the management of supraventricular tachycardia.

METHODS

We conducted a randomised, controlled, study at two Welsh medical schools. Participants were graduate-entry and undergraduate medical students, who were randomised (in a 1:1 ratio) to either 1 hour of training using an e-learning package or an hour of lecture-based teaching. The outcome was a comparison, within each group and between groups, of median scores achieved in assessments of knowledge through completion of preintervention, immediate post intervention and 2 weeks postintervention questionnaires.

RESULTS

Of the 97 participants available for randomisation, 47 underwent teaching using the e-learning package and 50 were taught in the lecture group. Median scores were higher in the e-learning package group than the lecture group, though this difference was not statistically significant (4.00 vs 3.00; p=0.08) immediately after intervention. At 2 weeks post intervention, median scores in the e-learning package group were significantly higher than the median scores in the lecture group (4.00 vs 3.00; p=0.002). This was despite a subanalysis of the results demonstrating that subjects in the lecture group reported having seen more cases compared with those in the e-learning group (32 vs 13; p=0.002). Further, there was a significant fall in score over 2 weeks in the group receiving lecture-based teaching, but no such decrease in those using the e-learning package.

CONCLUSION

E-learning seems to be the preferred method of learning and the method that confers longer retention time for both postgraduate and undergraduate medical students.

Aligning Practice Data and Institution-specific CPD: Medical Quality Management as the Driver for an eLearning Development Process

For hospital physicians, alignment of Continuing Professional Development (CPD) with quality improvement efforts is often absent or rudimentary. The purpose of this study was to evaluate a CPD development process that created accessible learning opportunities and aligned CPD with practice data. We conducted a chart audit to identify patient safety and quality of care issues within the institution, then established an eLearning approach that supported quick and cost effective development of high-quality interactive CPD opportunities. We tested a pilot module on the management of common infections in sub-acute care settings with fifteen (68%) residents and three staff physicians to evaluate the approach. One resident and three staff agreed to a follow-up interview. The satisfaction survey indicated that participants felt the content was generally appropriate and the module well designed. Significant improvements to knowledge were reported in the multi-drug resistance (Mean Difference = 25%, p = 0.002), infection management (MD = 32%, p < 0.001), and cellulitis risk factor (MD = 22%, p = 0.02) questions, as well as in the overall score (MD = 19%, p < 0.001). In terms of confidence in their answers, the mean rating pre-module was 3.17, rising significantly to 3.92 post-module (p < 0.001). In this way, collaboration between quality management and education committees allowed for the development of relevant CPD for physicians, with eLearning providing a timely and accessible way to deliver training on emerging issues.

Utilization of an online module bank for a research training curriculum: development, implementation, evolution, evaluation, and lessons learned

BACKGROUND

Students enter Oakland University William Beaumont School of Medicine's required research program, Embark, with variable levels of experience. Recognizing this, Embark allows for progression through the individual research project with flexibility. Since 2014, student self-directed curriculum personalization is promoted through a menu of online modules.

OBJECTIVE

This evaluation sought to understand student usage of the modules, identified strengths of the modules and preferred attributes of the modules. Gaining this evidence will provide information on how to best meet students' needs in a just-in-time format.

METHODS

A retrospective mixed methods analysis of the module library was conducted. The library was constructed using best practices as an educational tool. The retrospective evaluation included analysis of students' viewing patterns and answers to required course evaluations during the fall semesters of 2014 to 2017. Students' preference for modules was determined by viewing records and conjoint analysis.

RESULTS

Students' milestone preparation was not negatively impacted by relocation of curricular content from lecture to modules. Changes in module implementation within the course (2016) resulted in an increase of students viewing modules beyond only the minimum course requirements (71% (2016) from 10% (2014)). Data from both quantitative and qualitative evaluation questions show an increase in students' identifying the modules as a strength to individualize the course. The identified module strengths include content individualization, just-in-time access, while identified needs included a desire for additional modules. Students preferred modules that were animated, shorter in duration and curated from an external source.

CONCLUSIONS

Online modules provide students with a rich set of resources allowing for individualized learning. Lessons learned in the implementation of the online modules may be transferable to many educational topics. When implementing similar technology projects, usage rates, learner feedback, and effect on appreciation of the content are important to frequently monitor.

A Practitioner's Guide to Performing a Holistic Evaluation of Technology-Enhanced Learning in Medical Education

Technology-enhanced learning (TEL) is now a common mode of educational delivery within medical education. Despite this upsurge, there remains a paucity in comprehensive evaluation of TEL efficacy. In order to make meaningful and evidence-informed decisions on 'how' and 'when' to utilise technology within a course, 'useful knowledge' is required to support faculty in these decision-making processes. In this monograph, a series of pragmatic and achievable approaches for conducting a holistic evaluation of a TEL resource intervention are detailed. These suggestions are based on an established TEL evaluation framework, as well as the author's own experience and that of the broader literature. The approaches cover development of an appropriate research question that is based on the availability of existing TEL resources alongside the peer-reviewed literature; the development of an appropriate team as well as recommendations for navigating ethical approval; conducting small-scale quantitative and qualitative measure; and performing a large-scale mixed methods assessment to understand the holistic impact of the TEL resource.

Developing Cognitive Skills Through Active Learning: A Systematic Review of Health Care Professions

Objective

To systematically review current literature to determine whether active learning is more successful than passive learning at producing cognitive skills in health care professions students.

Data Sources

An electronic search was conducted in 4 databases: EBSCO-CINAHL, EBSCO-Sport Discus, Educational Resources Information Center, and PubMed. Search terms included: millennial AND health education, active learning AND knowledge retention, flipped classroom AND learning outcomes, problem based learning AND learning outcomes, problem based learning AND student confidence, active learning AND critical thinking, higher order thinking AND active learning.

Study Selection

We included studies if they were published in English between 2007 and 2017 and evaluated outcomes of an active learning intervention. Studies of nonhealth care disciplines, practicing health care practitioners, or studies that did not address the primary research questions were excluded.

Data Extraction

Study design, health care discipline, intervention used, assessment measures, outcome(s) measures, main results, and conclusions were extracted from each article, as appropriate.

Data Synthesis

Articles were categorized based on capacity to answer 1 or both of the research questions. Conclusions were summarized according to the learning technique used and its effectiveness in regard to studied learning outcome. Out of 85 studies on lower-order cognition, 61 (72%) indicated active learning techniques were effective at achieving improved recall, understanding, and/or application of course material. Of 69 studies on higher-order cognition, 58 (84%) supported active learning over passive instruction for improving students' confidence in or performance of analytical, evaluative, and creative skills.

Conclusions

Active learning produces gains to both lower- and higher-order cognition at levels equal to, and more often, greater than the use of passive learning methods. Despite this evidence, we believe more high-quality, well-designed prospective studies using validated assessment measures are needed to endorse the value of these methods in producing cognitive skills.

Ten tips to encourage student interaction with screen-capture type vodcasts

Video podcasts (vodcasts) are gaining popularity in medical education, but they can be a passive learning modality if students do not actively engage with the content. Of the two categories of vodcast software, screen-capture (mp4 output) and Flash™ (HTML5/Flash output), screen-capture has greater potential to result in passive learning because students cannot physically interact with the content. However, screen-capture offers several advantages for the producer (often faculty) and the consumer (students). As such, this type of software is popular with medical school faculty. To encourage active learning, ten tips are presented with specific strategies that faculty can use with screen-capture type vodcasts. Many of the tips also apply to Flash-type vodcasts. By incorporating these strategies, faculty with limited technical abilities can create engaging vodcasts that stimulate active learning.

Faculty motivations to use active learning among pharmacy educators

INTRODUCTION

Faculty motivations to use active learning have been limited to surveys evaluating faculty perceptions within active learning studies. Our objective in this study was to evaluate the relationship between faculty intrinsic motivation, extrinsic motivation, and demographic variables and the extent of active learning use in the classroom.

METHODS

An online survey was administered to individual faculty members at 137 colleges and schools of pharmacy across the United States. The survey assessed intrinsic and extrinsic motivations, active learning strategies, classroom time dedicated to active learning, and faculty development resources. Bivariate associations and multivariable stepwise linear regression were used to analyze the results.

RESULTS

In total, 979 faculty members completed the questionnaire (23.6% response rate). All motivation variables were significantly correlated with percent active learning use (p < 0.001). Intrinsic motivation demonstrated the highest correlation (r = 0.447) followed by current extrinsic motivations (r = 0.245) and ideal extrinsic motivations (r = 0.291). Variables associated with higher intrinsic motivation included the number of resources used (r = 0.233, p < 0.001) and the number of active learning methods used in the last year (r = 0.259, p < 0.001). Years of teaching experience was negatively associated with intrinsic motivation (r = -0.177, p < 0.001). Regression analyses confirmed the importance of intrinsic and extrinsic motivations in predicting active learning use.

DISCUSSION AND CONCLUSIONS

Our results suggest that faculty members who are intrinsically motivated to use active learning are more likely to dedicate additional class time to active learning. Furthermore, intrinsic motivation may be positively associated with encouraging faculty members to attend active learning workshops and supporting faculty to use various active learning strategies in the classroom.

Formative research for the nationwide promotion of a multidisciplinary community-based educational program on end-of-life care

Although one of the most important missions of end-of-life education is to ensure proper inter-professional education (IPE), in Japan, end-of-life care IPE has not been given enough attention especially in community settings. This study aims at developing an effective workshop facilitator training program on end-of-life care IPE and acquiring the know-how to set up and efficiently run administrative offices. We first developed a tentative facilitation training program and conducted it in five cities nationwide. The training strategy was as follows: (1) participating in the workshop, (2) attending a lecture on facilitation, (3) conducting a preparatory study, (4) attending one workshop session as a facilitator, and (5) reflecting on one’s attitude as a facilitator based on workshop participants’ questionnaire, peer-feedback, and video recording. A total of 10 trainees completed the training program. We assessed the level of improvement in the trainees’ facilitation skills and the efficacy of the training course using a qualitative approach. This formative study helped us identify several aspects needing improvement, especially in the areas of information technology and social media. Progress in these areas may have a positive impact on the education of community health care professionals whose study hours are limited, helping provide continued facilitation training.